• Medical Director - Medicare

    Elevance Health (Miami, FL)
    ** Medicare Medical Director ** Location: This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while ... Candidates must be able to work Eastern Time Zone hours. The ** Medicare Medical Director ** is responsible for the administration of physical and/or… more
    Elevance Health (05/20/25)
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  • Medical Director ( Medicare )

    Molina Healthcare (Miami, FL)
    …quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to ... Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews...experience, including: + 2 years previous experience as a Medical Director in a clinical practice. +… more
    Molina Healthcare (05/02/25)
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  • National Director , Clinical…

    ChenMed (Miami, FL)
    …previous experience as Medical Director or Associate Medical Director or equivalent with a Medicare or Medicaid patient population preferred + ... expanding and we need great people to join our team. The National Director , Clinical Effectiveness will collaborate with the Market Clinical Directors to enhance… more
    ChenMed (05/21/25)
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  • APP, Supervisor - General Internal Medicine - Full…

    University of Miami (Miami, FL)
    …when necessary + Performs other duties as assigned by the Chief and/or clinic Medical Director + Experience with Medicare Advantage (65+) patient population ... evaluations. This role also works directly with staff, administration, medical directors, and other relevant stakeholders to assure appropriate...preferred + Completion of Medicare annual wellness exam documentation preferred + Knowledge of… more
    University of Miami (03/17/25)
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  • Medical Director Specialty…

    Molina Healthcare (Miami, FL)
    **JOB DESCRIPTION** **Job Summary** The Medical Director for Specialty Medical Services & Market Performance will provide clinical expertise and support to ... quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to… more
    Molina Healthcare (04/09/25)
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  • Medical Director , Behavioral Health

    Molina Healthcare (Miami, FL)
    …Certification in Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in ... State Medical License, free of sanctions from Medicaid or Medicare . **Preferred Experience** * Peer Review, medical policy/procedure development, provider… more
    Molina Healthcare (04/26/25)
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  • Director , Appeals & Grievances (Texas)

    Molina Healthcare (Miami, FL)
    …with the standards and requirements established by the Centers for Medicare and Medicaid **Knowledge/Skills/Abilities** * Leads, organizes, and directs the ... to members or authorized representatives in accordance with Centers for Medicare and Medicaid standards/requirements. * Provides direct oversight, monitoring and… more
    Molina Healthcare (05/14/25)
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  • Location Director

    Aveanna Healthcare (Fort Lauderdale, FL)
    Location Director ApplyRefer a FriendBack Job Details Requisition #: 204959 Location: Fort Lauderdale, FL 33309 Category: Management Salary: $65,000.00 - $70,000.00 ... per year Position Details Executive Director Position Overview Step into an exciting leadership role...future of home care excellence! As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
    Aveanna Healthcare (05/06/25)
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  • Client Relations Sales Director

    Aveanna Healthcare (Fort Lauderdale, FL)
    Client Relations Sales Director ApplyRefer a FriendBack Job Details Requisition #: 205282 Location: Fort Lauderdale, FL 33309 Category: Client Services Salary: ... Essential Job Functions * Market Private Duty Nursing, Therapy Services, and Medical Solutions to existing and potential referral sources to achieve established… more
    Aveanna Healthcare (05/23/25)
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  • Director - Financial Operations (Hospital)

    Trinity Health (Fort Lauderdale, FL)
    …with experience in working in a complex delivery system with a multi-specialty medical group and a Medicare Advantage health plan.** **Our Commitment to ... Diversity and Inclusion** Trinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues… more
    Trinity Health (04/15/25)
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  • Clinical Pharmacist - Managed Care

    DOCTORS HEALTHCARE PLANS, INC. (Coral Gables, FL)
    …other constituents, including but not limited to: Pharmacy Director , Chief Medical Officer, Medical Director , Pharmacy team, Member Services, Utilization ... assist in the development, administration and management of the Health Plan's Medicare Prescription Drug Program, including compliance and oversight of Medicare more
    DOCTORS HEALTHCARE PLANS, INC. (05/23/25)
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  • Primary Care Physician

    CenterWell (Plantation, FL)
    medical expertise with the care team through daily huddles. . Helps Regional Medical Director and Center Administrator in setting a tone of cooperation in ... Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators… more
    CenterWell (05/23/25)
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  • Primary Care Physician

    CenterWell (Pembroke Pines, FL)
    medical expertise with the care team through daily huddles. . Helps Regional Medical Director and Center Administrator in setting a tone of cooperation in ... Doctors, Advanced Practice professionals, Pharm D, Care Coach Nurses, Medical Assistants, Behavioral Health, Specialists, Quality Based Coders, Referral Coordinators… more
    CenterWell (05/13/25)
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  • Home Health MSW Master Social Worker PRN

    Aveanna Healthcare (Miami, FL)
    …the client's physician, therapists or other care givers. + Provide input to the Medicare Director regarding the need for formulation or modification of agency ... on clinical diagnosis, client and physician input that includes medical and social interventions and measurable goals or outcomes....work experience + Valid CPR As an employer accepting Medicare and Medicaid funds, employees must comply with all… more
    Aveanna Healthcare (05/20/25)
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  • Cell Therapy Market Access Manager - Southeast

    Bristol Myers Squibb (Miami, FL)
    …bill therapy reimbursement experience including: + Coverage, coding, billing and payment + Medicare (NCD, IPPS, OPPS, 340B, etc.) + Medical policy, managed care ... within the assigned territory. The CMAM will report into the East Region Director , Cell Therapy Market Access Managers. The individual is required to achieve all… more
    Bristol Myers Squibb (05/07/25)
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  • Case Mgr RN PRN

    HCA Healthcare (Plantation, FL)
    …and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low ... as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision...Rehab patient. The CM collaborates with the Rehab Program Director and Facility Case Management Director regarding… more
    HCA Healthcare (03/21/25)
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  • Claims Adjuster

    Carnival Cruise Line (Miami, FL)
    …and analyzing each claim against incident reports, shipboard and shoreside medical records and the applicable employment agreement. This role requires addressing ... such as missing or incomplete shipboard incident reports and post-employment medical records, as well as managing unreasonable demands from plaintiff attorneys… more
    Carnival Cruise Line (04/03/25)
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  • RN Case Mgr PRN

    HCA Healthcare (Aventura, FL)
    …and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low ... as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision...Rehab patient. The CM collaborates with the Rehab Program Director and Facility Case Management Director regarding… more
    HCA Healthcare (05/18/25)
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  • RN Case Manager

    HCA Healthcare (Miami, FL)
    …and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low ... as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision...Rehab patient. The CM collaborates with the Rehab Program Director and Facility Case Management Director regarding… more
    HCA Healthcare (04/10/25)
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  • Case Mgr RN

    HCA Healthcare (Tamarac, FL)
    …and retirement of our colleagues. The available plans and programs include: + Comprehensive medical coverage that covers many common services at no cost or for a low ... as well as free telemedicine services and free AirMed medical transportation. + Additional options for dental and vision...Rehab patient. The CM collaborates with the Rehab Program Director and Facility Case Management Director regarding… more
    HCA Healthcare (05/15/25)
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